Washington, D.C., Aug. 7, 2022 — The Leukemia & Lymphoma Society (LLS) joins cancer patients nationwide in celebrating the passage of key healthcare reforms in the Inflation Reduction Act of 2022 by the U.S. Senate, including an out-of-pocket limit in Medicare Part D and extension of premium subsidies that have made quality insurance more affordable for lower-income patients.
For years, patients experiencing blood cancer and other serious conditions have been subject to limitless treatment costs through Medicare Part D, often totaling $10,000 or more out-of-pocket each year for a single drug. The new bill dramatically lowers those costs for patients — both across the year and in any one trip to the pharmacy — enabling more patients to access lifesaving treatments.
“We’re elated for—and alongside—cancer patients who have been advocating for these reforms for years,” said Gwen Nichols, M.D., LLS Chief Medical Officer. “A meaningful out-of-pocket cap ensures Medicare Part D patients will no longer have to regularly make the impossible choice between paying for treatment and paying for living expenses.”
The legislation’s new $2,000 cap on Medicare patients’ out-of-pocket prescription drug costs allows patients to pay that expense incrementally over the course of the year. Today, these patients face limitless prescription drug costs, and their payments are frontloaded at the start of the year.
LLS and blood cancer advocates have long urged lawmakers to make this critical reform, which is a life-or-death issue for patients. More than 40 percent of Medicare enrollees abandon their cancer treatment when they are required to spend more than $2,000 on a single prescription.
LLS is also encouraged by the extension of new enhanced Advance Premium Tax Credits (APTCs) that make health insurance premiums on Healthcare.gov more affordable for millions of Americans through 2025. Experts project that, without this extension, 3 million people would lose their insurance coverage, while millions more would be forced to pay higher premiums for the same coverage.
“Cancer care is so expensive that it’s nearly impossible for patients to get treatment unless they have health insurance,” Nichols said. “This support means millions more people will have access to quality, affordable cancer care if they need it.”
Once enacted, these two provisions will mark the most significant steps in more than a decade towards expanding quality, affordable healthcare to all Americans—including cancer patients and survivors. LLS urges the U.S. House of Representatives to pass this legislation quickly so President Biden can sign it into law. “We need Congress to get this across the finish line,” Nichols said. “Patients don’t have the luxury of waiting.”
Once these reforms are signed into law, Congress should turn its attention to permanently closing the Medicaid coverage gap, which has left more than 2 million people with low incomes without an affordable coverage solution. The majority of the people in the coverage gap are people of color, and studies demonstrate that people of color are more likely to abandon cancer treatments because of high costs. LLS is deeply disappointed that Congress failed these patients by leaving this critical reform out of the current package, and we urge Congress and states to swiftly revisit this priority in future legislation.
Media Contact:
Ryan Holeywell
Senior Director, Advocacy Communications
ryan.holeywell@lls.org
About The Leukemia & Lymphoma Society
The Leukemia & Lymphoma Society® (LLS) is a global leader in the fight against cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world, provides free information and support services, and is the voice for all blood cancer patients seeking access to quality, affordable, coordinated care.